Development a New Biliary Reconstruction Using Antireflux Intestinal Spur Valve

本研究旨在建立肠道抗反流骨刺瓣膜的最佳构建方法，以预防肝门肠造口术及类似情况下的升型胆管炎。材料与方法：选取体重10 ~ 20kg的雌雄杂种犬14只，其中2只作为对照。对所有犬，通过剥去空肠导管远端一侧的血清肌层，然后将剥脱区域的边界与十二指肠缝合，构建骨节瓣。6只狗的瓣膜大小为2cm， 6只狗的瓣膜大小为5cm，其余2只对照狗未构建瓣膜。进行了测压、钡检查和组织病理学检查。结果：结果分为差、一般、良好。对照犬无瓣膜动作，容易观察到反流。在瓣膜大小为2cm的狗中，6个中有4个表现良好，2个表现一般。而在5cm大小的瓣膜中，6个中有3个是好的，2个是差的，1个是一般的。正常和良好病例的开启压力范围为11 ~ 20cmh20。瓣膜抗反流机制的效果在后期检查中优于早期检查，这是由于瓣膜内最初的轻度炎症过程。

We conducted this study to establish the best method for construction of intestinal antireflux spur valve which could be beneficial in prevention of ascending cholangitis in cases treated by hepatic portoenterostomy and similar conditions.Materials and Methods :Fourteen Mongrel dogs of both sexes weighing from 10-20Kg were used, among which 2 dogs served as control. For all dogs, a spur valve was constructed by denuding the seromuscular layer of one side of the distal end of the jejunal conduit and then suturing the boundries of the denuded area to the duodenum. The size of the valves was 2cm in 6 dogs, 5cm in 6 dogs and no valve was constructed in the remaining 2 control dogs. Manometric studies, barium studies and histopathological studies were performed.Results :Results were expressed as poor, fair and good. In control dogs there was no valve action and reflux could be observed easily. In dogs with 2cm sized valve 4 out of 6 showed good results and 2 fair. While in dogs with 5cm sized valve 3 out of 6 were good, 2 poor and 1 fair. Opening pressure in fair and good cases ranged from 11 to 20 cmH20. The efficacy of the valve for anti-reflux mechanism was better in later examinations than in earlier ones and it was due to the initial mild inflammatory process within the valve.